Hepatology Hepatitis C
Tsui JI. JAMA Intern Med. 2014;174:1974-1981.
December 26, 2014
Young adult injection drug users showed a decreased incidence rate for hepatitis C virus infection after undergoing maintenance opioid agonist treatment, according to study data.
Researchers, including Judith I. Tsui, MD, MPH, of the department of medicine at Boston University School of Medicine, conducted an observational cohort study with 552 injection drug users from San Francisco negative for anti-HCV antibody or HCV RNA between 2000 and August 2013. All of the patients were younger than 30 years and underwent HCV testing and reported any substance use treatment every 3 months. Options for treatment for substance use reported by the patients included non-opioid agonist methods, opioid agonist methods, detoxification or maintenance therapy, or no treatment at all.
During observation (680 person-years), 171 cases of HCV occurred per 100 person-years, indicating an incidence rate of 25.1 per 100 person-years. The incidence rate for HCV was lower in patients who underwent recent maintenance opioidagonist therapy (0.31; 95% CI, 0.14-0.65) compared with patients who underwent non-opioid agonist therapy (0.63; 95% CI, 0.37-1.08), opioid agonist detoxification (1.45; 95% CI, 0.8-2.69) and no treatment.
Sensitivity analysis showed a lower incidence of HCV in patients who underwent opioid agonist therapy compared with patients receiving no treatment (RR=0.37; 95% CI, 0.14-1.02). However, HCV incidence was not lower in patients who underwent opioid agonist detoxification (RR=1.77; 95% CI, 0.95-3.32).
“Our results suggest that treatment for opioid use disorders with maintenance opioid agonist therapy can reduce transmission of HCV in young adult injection drug users and should be offered as an important component of comprehensive strategies for prevention of primary HCV infection,” the researchers concluded.
Disclosure: The study was funded through multiple grants from the National Institutes of Health.